Antibody Levels and Protection After Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose

J Infect Dis. 2016 Jul 1;214(1):16-22. doi: 10.1093/infdis/jiv748. Epub 2016 Jan 21.


Background: The duration of protection in children and adults resulting from hepatitis B vaccination is unknown. In 1981, we immunized a cohort of 1578 Alaska Native adults and children from 15 Alaska communities aged ≥6 months using 3 doses of plasma-derived hepatitis B vaccine.

Methods: Persons were tested for antibody to hepatitis B surface antigen (anti-HBs) levels 30 years after receiving the primary series. Those with levels <10 mIU/mL received 1 booster dose of recombinant hepatitis B vaccine 2-4 weeks later and were then evaluated on the basis of anti-HBs measurements 30 days after the booster.

Results: Among 243 persons (56%) who responded to the original primary series but received no subsequent doses during the 30-year period, 125 (51%) had an anti-HBs level ≥10 mIU/mL. Among participants with anti-HBs levels <10 mIU/mL who were available for follow-up, 75 of 85 (88%) responded to a booster dose with an anti-HBs level ≥10 mIU/mL at 30 days. Initial anti-HBs level after the primary series was correlated with higher anti-HBs levels at 30 years.

Conclusions: Based on anti-HBs level ≥10 mIU/mL at 30 years and an 88% booster dose response, we estimate that ≥90% of participants had evidence of protection 30 years later. Booster doses are not needed.

Keywords: 30 years; Alaska; Alaska Native; US; anti-HBs; antibody; cohort; hepatitis B; immunogenicity; plasma-derived vaccine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alaska
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatitis B / immunology
  • Hepatitis B / prevention & control*
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Antibodies / immunology*
  • Hepatitis B Vaccines / immunology*
  • Humans
  • Immunity, Active / immunology*
  • Immunization, Secondary*
  • Male
  • Middle Aged
  • Time Factors
  • Young Adult


  • Hepatitis B Antibodies
  • Hepatitis B Vaccines